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Pendulum of Ages from 
Sands of Time at level 20.
Shoes of Focus late game for 
Soul Reaver or an alternative, such as 
Staff of Myrddin
Spear of the Magus could be 
Divine Ruin
This is your standard Tiamat Mid build. Upgrade Pendulum of Ages from Sands of Time at level 20.
Swap Shoes of Focus late game for Soul Reaver or an alternative, such as Staff of Myrddin
An alternative to Spear of the Magus could be Divine Ruin
Pendulum of Ages
Shoes of Focus
Rod of Tahuti
Spear of the Magus
Soul Gem
Obsidian Shard
Elixir of Speed
Soul Reaver
Shoes of Focus and upgrades into Pendulum of Ages at level 20.
This is your standard Mid start for CDR.
This start builds into Shoes of Focus and upgrades into Pendulum of Ages at level 20.
Sands of Time
Lost Artifact
Healing Potion
Mana Potion
Shoes of Focus and upgrades into 
Archmage's Gem at level 20.
This is your Mid start for wave clear and late game damage.
This start builds into Shoes of Focus and upgrades into Archmage's Gem at level 20.
Conduit Gem
Magic Focus
Healing Potion
Mana Potion
Shoes of Focus and upgrades into 
Sacrificial Shroud at level 20.
This is your safe lane start with high late game damage.
This start builds into Shoes of Focus and upgrades into Sacrificial Shroud at level 20.
Vampiric Shroud
Lost Artifact
Healing Potion
Mana Potion
Pendulum of Ages from Sands of Time at level 20. Shoes of Focus late game for Soul Reaver or an alternative, such as Staff of Myrddin Spear of the Magus could be Divine Ruin
Upgrade Pendulum of Ages from Sands of Time at level 20.
Swap Shoes of Focus late game for Soul Reaver or an alternative, such as Staff of Myrddin
An alternative to Spear of the Magus could be Divine Ruin
Pendulum of Ages
Shoes of Focus
Rod of Tahuti
Spear of Desolation
Spear of the Magus
Obsidian Shard
Elixir of Speed
Soul Reaver
Archmage's Gem from Conduit Gem at level 20. Shoes of Focus late game for Staff of Myrddin or an alternative, such as Soul Reaver Spear of Desolation could be Divine Ruin
Upgrade Archmage's Gem from Conduit Gem at level 20.
Swap Shoes of Focus late game for Staff of Myrddin or an alternative, such as Soul Reaver
An alternative to Spear of Desolation could be Divine Ruin
Archmage's Gem
Shoes of Focus
Spear of Desolation
Rod of Tahuti
Soul Gem
Obsidian Shard
Elixir of Speed
Staff of Myrddin
Sacrificial Shroud from Vampiric Shroud at level 20. Shoes of Focus late game for Staff of Myrddin or an alternative, such as Soul Reaver Spear of Desolation could be Divine Ruin
Upgrade Sacrificial Shroud from Vampiric Shroud at level 20.
Swap Shoes of Focus late game for Staff of Myrddin or an alternative, such as Soul Reaver
An alternative to Spear of Desolation could be Divine Ruin
Sacrificial Shroud
Shoes of Focus
Rod of Tahuti
Spear of Desolation
Soul Gem
Obsidian Shard
Elixir of Speed
Staff of Myrddin
These are all alternative or situational damage items that can work on Tiamat to counter the enemy team or not feel as weak into certain comps/items.
They do NOT need to be built every single game.
Charon's Coin
Chronos' Pendant
Divine Ruin
Doom Orb
Ethereal Staff
Gem of Focus
Soul Reaver
Staff of Myrddin
These are all alternative or situational defence items that can work on Tiamat to counter the enemy team or not feel as weak into certain comps/items.
They do NOT need to be built every single game.
Magi's Cloak
Mantle of Discord
Relic Dagger
Winged Blade
Purification Beads and 
Aegis Amulet are the main two that you will be picking up, the others do NOT need to be built every single game.
These are all of the relics that can work on Tiamat to counter the enemy team or not feel as weak into certain comps/items.
Purification Beads and Aegis Amulet are the main two that you will be picking up, the others do NOT need to be built every single game.
Purification Beads
Aegis Amulet
Magic Shell
Blink Rune
Y
B
A
X
Primordial Onslaught (Flying): Tiamat gathers power, allowing her to fire orbs of energy at the end of the channel. Each orb damages enemies and stops on enemy gods. Hitting the same enemy deals 15% less damage each time, to a minimum of 70% reduction. This ability can fire additional projectiles at ranks 3 and 5.
Consume (Ground): Tiamat fires a cone dealing damage and slowing enemies hit. Minions, Large Monsters or Buff Holders hit under a health threshold are executed. Tiamat can immediately consume her Serpent and Beast pets to provide a Hardened Scale. When Tiamat consumes a Buff Holder she gains their buff while the original can still be picked up by allies. This allows Tiamat to pick up a second buff as well. Tiamat can only have one consumed and one regular buff at a time.
Ruination (Flying): Tiamat creates an energy field dealing low damage to enemies in the entire area and then a larger amount in the inner area. The inner area of the field also stuns enemies for a short duration.
Outburst (Ground): Tiamat slams the ground creating seismic rifts that erupt in succession in front of her, damaging and knocking up enemies hit.
Grounding Dive (Flying): Tiamat dives into the fight landing on all fours, dealing damage and switching to her Ground stance. This ability also provides Tiamat one Hardened Scale.
Rising Flight (Ground): Tiamat rears up sending out a blast of energy, dealing damage to enemies and sending herself backwards as she returns to her Flying stance.
Children of Creation (Flying): Tiamat is able to summon one of her children onto the battlefield.
Summon Serpents (Summon #1): Serpents that travel down lanes and act as minions.
Summon Beast (Summon #2): Kusarikku who stands guard waiting for enemy gods.
Summon Storm (Summon #3): Umu Dabrutu, the storm that chases enemies.
Tempest of Undoing (Ground): Tiamat causes a celestial outburst around her, dealing initial damage and a damage over time effect to every enemy nearby. Tiamat also gains one Hardened Scale per enemy god hit.
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Blood-Soaked Shroud
Protector Of The Jungle
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